[unreadable] [unreadable] Despite advances in cancer therapy, discrepancy in the morbidity and mortality rates of oral cancer among minority patients has remained unchanged. Tobacco and alcohol consumption have been associated as risk factors in oral cancer, however, these habits fail to explain all cases of head and neck malignancy. Human papilloma virus (HPV), a well established risk factor in invasive cervical cancer, has also been identified in several oral pre-cancerous lesions. A pilot study of head and neck cancer and HPV screening using the Roche Linear Array HPV genotyping test conducted at Los Angeles County-University of Southern California (LAC- USC) medical center during 2005-2006 has demonstrated that 45% of tumor specimens were HPV positive at any time with 100% of positive tumors harboring HPV 16. In the past decades, HPV infection has become one of the most prevalent sexual transmitted infections in the underserved communities, Hispanics and African Americans, as compared to other ethnic groups. The overall objective of this study is to determine whether HPV is related to oral pre-malignant cancer and oral cancer in minority patients living in Los Angeles County and to identify inflammation-associated biomarkers as diagnostic and prognostic tools for oral cancer progression. The following specific aims will be addressed in this study: 1) To determine the association between human papilloma virus infection and oral leukoplakia among a minority population, African Americans and Hispanics, living in Los Angeles County; and 2) To evaluate pro-inflammatory and anti-inflammatory cytokines associated with HPV infected patients and oral leukoplakia as biomarkers for oral cancer progression. The specific objective is to identify potential inflammatory biomarkers in HPV-associated oral pre-cancer which may be used to identify high-risk subgroups among African American and Hispanic populations and to tailor appropriate intervention strategies to reduce the incidence of oral cancer among these populations. The relationship between lifestyle factors, such as tobacco smoking, alcohol consumption and HPV infection, and genetic host factors will be studied using a hospital-based case-control design. The findings from this pilot study will lead to a future R01 application with potential to improve the quality of cancer epidemiologic research and reduce the oral cancer burden in minority populations. [unreadable] [unreadable] [unreadable]